Student Organization Membership Enrollment Form 2012-2013

The president of a student organization has identified you as a member and/or officer of a student organization. Please complete the following form to be considered a member of the named student organization for the 2012-2013 academic year. You'll need to complete this form more than once if you're a member of more than one organization.

In the years following, you will be asked to submit this form to renew your membership. At any time you might choose to join another student organization, or take on a leadership role—in both of these cases, you will also need to submit this form so that the organization has updated information with the Office of Student Activities.

Residence Hall/Room Number or place of residence while attending Elmhurst College

This is a required question

Organization Name
*

This is a required question

Membership Type
*

General Member

Officer

This is a required question

Officer Title

This is a required question

Grade Disclosure
*

I understand that my consent is required by the Family and Education Rights Privacy Act of 1974, as amended, (FERPA) for the Registrar’s Office to release my grades to someone other than myself. As a member of the organization above, I hereby authorize the Registrar’s Office to disclose my grade report to the Office of Student Activities and the staff and/or advisor(s), at the end of each term until I graduate, leave the College, or resign my membership. I understand this information will be used to scholastic programs, advising and grade reports. I understand that this release does not permit the disclosure of these records to any person without my consent. I understand that this release will terminate at the end of my enrollment at Elmhurst College, leave the College, or resign my membership, or by providing a written request to the Office of Student Activities..

Yes

No

This is a required question

Anti-Hazing Compliance
*

Elmhurst College prohibits conduct by an individual, organization or group affiliated with the College that is in violation of the Illinois Law on Hazing, or any hazing activity which threatens a person’s rights or self respect, which disrupts community life, or which encourages the violation of civil, state or federal law, or an Elmhurst College Code of Conduct. Hazing is a demeaning and dangerous practice that has no legitimate purpose. Elmhurst College considers the following behaviors and activities to constitute hazing that may lead to group and/or individual disciplinary action: actions that endanger the physical or mental health or safety of a student or other person; forced, coerced or required consumption of any food, liquor, drug, or any other substance; forced, coerced or required participation in physical activities, such as calisthenics, exercises or so-called “games”; exposure to the weather; excessive fatigue resulting from sleep deprivation, physical activities, or exercises; assignment of activities that would be illegal or unlawful or could be morally offensive to individuals; physical abuse, including but not limited to paddling, striking with fists, open hands or objects, and branding; kidnapping, transportation, or stranding of individuals; verbal abuse or harassment, including but not limited to “lineups” and berating of individuals; forced, coerced or required conduct that could demean, embarrass, humiliate, or adversely affect the dignity of the individual, including but not limited to the wearing of apparel that is conspicuous or extraordinary and the performance of public stunts and activities; the intentional creation of clean-up work for organizations, other students, or alumni; defacement, damage, or destruction of property; denial of sufficient time to study; and nudity or other lewd or unbecoming behavior. This definition extends to and prohibits the same activities both on campus and off campus, including activities taking place at or on privately owned facilities and property.Hazing is typically associated with membership selection and initiation into an organization. It is possible for hazing to occur before, during, and after membership selection into an organization. Elmhurst College will investigate all hazing allegations. Individuals and organizations found in violation of the Elmhurst College Hazing Policy will be sanctioned and turned over to the proper law enforcement agency. If you believe you or someone you know has been a victim of hazing, contact Campus Security at 630-617-3000. I agree that I have read and understand the Elmhurst College Anti-Hazing Policy. I agree to comply with this policy, local and state laws, the polices of my fraternal organization and national governing council to which my organization belongs.

Yes

No

This is a required question

Photo Release
*

I grant permission to the Office of Student Activities for the use of the photograph(s) or electronic media images in any presentation of any kind. I understand that I may revoke this authorization at any time by notifying the Office of Student Activities in writing. The revocation will not affect any actions taken before the receipt of this written notification.